National Provider Identifier Database

ALLEGIANCE TO SELF RECOVERY
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

ALLEGIANCE TO SELF RECOVERY
3711 W BROADWAY
LOUISVILLE, KY40211-2847
Phone: 502-322-2065
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Case Management 251B00000X
Community/Behavioral Health 251S00000X
Mental Health 101YM0800X
Recovery Care 261QR0800X
Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for ALLEGIANCE TO SELF RECOVERY

NPI Number 1144044728
Legal business name
LBN
ALLEGIANCE TO SELF RECOVERY
Authorized official ANTWONE SHAW - (CEO)
Entity Organization
Organization subpart No
Enumeration date 11/11/2024
Last updated 12/10/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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